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to hope that the report on mid Staffs hospital will shake up the NHS?

(173 Posts)
grovel Wed 06-Feb-13 17:47:44

It was just awful and everyone from the then government through management to clinicians and nurses come out of it badly.

I don't for one moment think it reflects all (or even much) of the NHS but it does suggest a direction of travel which needs to be reversed - from caring service to self-obsessed bureaucracy.

YANBU.
I refuse a hospital here, the one I'm supposed to go to because of appalling care, I swear, the only reason I'm alive is because I discharged myself.
(RAH in Paisley btw)

LurkingBeagle Wed 06-Feb-13 17:52:40

YANBU to hope for a shake-up.
I think YAB slightly U to think it doesn't reflect on much of the NHS - the report could so easily have been written about parts of all of the NHS hospitals I have ever been in.
Personally I hope it engenders a positive and sensible debate about healthcare that acknowledges the weaknesses in our system and tries to adopt some of the strengths of (say) the French or Swiss system. I am all for the duty of candour too - not before time smile

it will, it already is, I have just started a support worker role and am on a training program and nearly everything we are learning is being linked back to the report. I havent had a chance to read the findings yet but I will over the next few days, but just feel reassured that the changes are already happening.

YANBU.
The sooner we stop trying our health service like a supermarket with a market economy, the better.

ConferencePear Wed 06-Feb-13 17:59:32

I haven't read this second report but I did get as far as page 146 on the first one. I had to stop reading at that point because I was so angry and upset.

Whatever the failings of the management structure, I cannot find any excuse why doctors, nurses and health care assistants should speak to patients as though they are sub-human nuisances.

grovel Wed 06-Feb-13 18:00:23

ditavonteesed, thank you. Good luck in your new role.

LurkingBeagle Wed 06-Feb-13 18:04:59

ConferencePear - I agree. But the fact is they do, every single day. One of the major issues I think we need to grapple with is how that kind of culture (i.e. where it is perfectly acceptable to treat patients like dirt) became embedded in a supposedly caring service.

It also must be the only time in history when 1000 odd people have died prematurely (and apparently unlawfully), and not one person is going to be tried or punished for it.

It really makes me so angry. Kudos to the families of victims - the report came about because of their campaigning and hopefully things will change drastically as a result.

grovel Wed 06-Feb-13 18:11:54

Lurking, I find that really astonishing too. I hope to God the answer isn't that they are simply reflecting the world outside.

meddie Wed 06-Feb-13 18:22:11

I find that hard to believe as well Conferencepear, but I can see how it happened.
You had a toxic culture where those who did try to raise concerns were bullied harrassed and forced out of their jobs.
Staff felt disenfranchised,stressed, not listened to and I suppose at some point they may have just given up, why should they give a crap if no one above them is and is penalising them from it.
The staffing levels were appalling and the skill mix was too. The majority of staffing on the wards was provided by untrained staff.
Nearly 1000 incident reports were filled in by staff highlighting unsafe staffing levels, poor care and problems. The were actually seen in a managers bin.

The NHS went down the pan when commercial managers were brought in and finance became god.

Before that hospitals were ran for the patients, suddenly these people were in charge who had no inkling of patient care and were target driven, Its very difficult to measure 'good care' but its easy to measure waiting times in a&e. So how was that managed?
Hospitals were fined for breaching the wait times, so instead of dealing with the issue of why this happened (not enough staff, inefficient systems) they fiddled the wait times, or invented side rooms off a&e called clinical decision units. So the patient even though still in a&e wasnt actually there on the figures.Instead they were stuck in a side room, overlooked and uncared for.
But the hospital managers could claim over 98% of people seen within 4 hours.
This is no indicator of quality of care, yet it became one.

The parts of the report I hope they take on board are:

a)Staffing levels and guaranteed safe minimums.
b) protection for whistle blowers, so staff can safely raise concerns without being bullied, harassed and witch hunted until they resign or are suspended.
c) regulation of HCA's . I have met some good ones but I have met some absolutely appalling ones. They never took the job because they wanted to its just a means to earn money and they dont care about the patients.
d)Managers have a duty of care to the patients, so they are penalised if they allow poor staffing and unsafe working practices to continue.

KatyPeril Wed 06-Feb-13 18:26:15

My Grandad was convinced that Matrons needed bringing back on the wards. Sadly, he died in Stafford hospital before christmas so won't get to see the outcome of all this.

KatyPeril Wed 06-Feb-13 18:27:08

I should point out he had good care! I think they've changed. It's a lot better than it was years ago (and I've a few stories)

tiredemma Wed 06-Feb-13 18:30:13

Every nurse in our hospital has been sent a pdf of the report (by our lead nurse) and is expected to attend a one of many planned sessions over the next few weeks to discuss its findings and how we 'change'.

XBenedict Wed 06-Feb-13 18:31:19

I really hope it shakes up the NHS and things change as a result. I have just completed a Return to Nursing course and I'm trying to now get a job.

I would LOVE to work on the wards but having small children I am unable to work unpredictable shifts and late shifts would be very very difficult however I could work during the day and night shifts but the local trust will only offer 24 hour 7 day a week contracts. I can't commit to that despite the ward I did my placement on asking me to apply for the vacancies they have. I wonder how many other nurses are in a similar situation.

LurkingBeagle Wed 06-Feb-13 18:32:11

All of my bad care examples were from 2006 - before Stafford and while the previous government were supposedly hosing money at the NHS.

Meddie - your post makes a lot of sense. Part of me can't help believing this is down to the sheer arrogance and lack of empathy of many medical professionals of all stripes. I have too much personal experience of it to believe it isn't also a factor here. (Sadly).

ajandjjmum Wed 06-Feb-13 18:37:15

I was shocked to hear that only 25% of the staff at Stafford would send a member of their own family to the hospital.

XBenedict - how many more good nurses are not being employed because of the inflexibility in rules?

And how does a degree teach you to care?

grovel Wed 06-Feb-13 18:39:27

meddie, thanks.

There were criticisms of staffing levels but my sense of the report is that it does not imply that Staffs needed much more money. It, and the wider NHS, needed to re-prioritise. Am I right?

iliketea Wed 06-Feb-13 18:47:21

I hope it does shake things up, in particular to sorting proper staffing levels and training for registered and unregistered staff.

I can see how it happened - staff report many many times to management about unsafe staffing levels / poor quality patient care and it gets completely ignored. At some point, staff get fed up being ignored and at such low staffing levels, end up burnt out and managent inaction gives the impression that staff concerns don't matter; in turn staff feel that they / the care provided doesn't matter and you end up with this situation. It's absolutely wrong, but I can see how it happens.

Understaffing is particularly rife on wards that have high needs patients e.g. elderly care where you may have 1 RN and 1-2HCAs for 15 or so patients. If even half of those need assistance with personal care, toileting, eating and drinking before any specific medical needs such as wound care / medication /obs are met it is a physical impossibilty to meet all those patient's needs. Having appropriate minimum staffing levels might help to improve standards of care.

I actually think GP comissioning will only make matters worse with more private companies providing healthcare with profit as the main goal - although the cynic in me thinks that it means DC could blame "private companies" rather than there being a problem in the NHS which costs money to sort out.

fridayfreedom Wed 06-Feb-13 18:52:46

Meddie, your post makes a lot of sense.
The worrying thing is that this could happen again... we continue to have staff shortages and with the focus on cutting costs very experienced staff are replaced with junior grades.
As for whistleblowing... people know there are things that are very wrong but they are worried about speaking out because so called annoymous routes to whistleblow are in fact identifiable. People can not afford to lose their jobs, especially those at a senior grade because there are no vacant posts around.
Those in charge very often come purely from business and have never worked at the coal face to see some of the awful situations people are in. There is a culture of let someother organisation pay for this so we save our own budget.
However this does not excuse poor patient care and neglect from those who are paid to care, a kind word and attention to dignity costs nothing!

timidviper Wed 06-Feb-13 18:57:59

I agree with what you've all said re staffing levels, priorities, etc but do think we also need to look at nursing training.

I work in the NHS and have been shocked, and I know a lot of my colleagues have too, at the attitudes, standards and lack of care shown by some (please note some, not all!) younger nurses. There seems to be more uncaring nurses coming through now that there ever used to be. A friend was recently hospitalised on the ward on which she was once senior sister and lodged a formal complaint about the nurses', she was appalled and stunned that those behaviours were tolerated.

meddie Wed 06-Feb-13 18:58:10

Its so complex its hard to know where to start, but hospitals cannot be run like sainsburys, with a target driven culture and tick boxes taking priority.
We need strong managers in place who value the patient care and experience above all else.

Staffing levels are desperately low in many parts of the country and there is a wealth of studies showing that the more patients a qualified nurse has responsibility for the higher the death rate. These are constantly ignored by those who make policy decisions because it costs money.
recommendations are 1 nurse to 7 patients, above that the death rate rises by approximately 7% for every patient over that number.

Some of our hospitals currently run with 12 to 15 patients per nurse.Its physically impossible to provide good care for all your patients in this scenario.

managers replace nurses with untrained and cheaper staff. So on paper they can say we have 4 staff to 28 patients but 2 of them are untrained so in reality that's 15 patients per qualified nurse.

Its a false economy. it leads to more complications thus longer stays, compensation claims and time taken in dealing with complaints etc.
USA,Australia and Canada all have legal nurse to patient ratios.

claig Wed 06-Feb-13 19:02:36

On Channel 4 News now.
Calls for a 'revolution' in the NHS.
4 trusts have worse figures than Mid Stafford.
Possibility of criminal charges if there is a failure to report nelect in future.

meddie Wed 06-Feb-13 19:07:36

I hope so. I think its the only thing that will make the bean counters sit up and take notice, if they faced punitive measures when they failed.

Pandera Wed 06-Feb-13 19:08:46

But surely the nurses involved in these cases played a huge part? They are on the front line and from what I can gather directly responsible for a lot of the charges.

poppypebble Wed 06-Feb-13 19:08:49

I've spent time in one of the hospitals now being urgently investigated because of the high mortality rates.

It was hell - because there were 2 nurses for an entire ward. My drip was not changed when it ran out - the alarm was simply silenced and that was it. I'd been admitted because my kidneys were shutting down with dehydration, but there simply wasn't time to change it. I was left to vomit all over myself and my bed and not cleaned up until my mum arrived and did it for me.

Luckily I wasn't too seriously ill, but had I been older or sicker I don't think I'd have survived.

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